Endoscopy archivos - Endoscopia y Colonoscopia en Medellín

SIBO : What can I do?

Posted on 30 June, 2022 by admin-mauricio

Small Intestinal Bacterial Overgrowth (SIBO) is an increase in the number of bacteria found in the small intestine.

In this organ there are less than 1000 bacteria per milliliter but in the case of SIBO these become hundreds of thousands or millions. These bacteria migrate from the colon or large intestine to the small intestine.

The increased number of bacteria causes a state of inflammation, which disrupts the intestinal barrier (leaky gut) or interferes with the absorption of nutrients

It also favors immune reactions that cause allergies, increased sensitivity to food or autoimmune problems.

The most common symptoms are pain or distention in the abdomen, diarrhea, flatulence, excessive bowel sounds, belching, weight loss, indigestion or heaviness. Do these annoyances sound familiar to you?

Other non-digestive symptoms that are common can be dullness or mental exhaustion and fatigue.

When you have these discomforts and you do not have an explanation of what causes them, I advise you to find out if you have SIBO

SIBO Small intestinal Bacterial Overgrowth Medellin — Photo taken from Pixabay

What can cause SIBO bacterial overgrowth?

There are three main causes that favor the appearance of SIBO:

Changes in the normal anatomy of the small intestine

Any intervention that touches or damages the small intestine can cause SIBO in the future. For example, if you have had a gastric bypass, peritonitis or have undergone radiotherapy

There may also be anatomical defects such as diverticula or strictures due to inflammation or tumors.

Abnormal movement of the small intestine

Diseases or conditions that slow down the movement of the small intestine will favor the proliferation of bacteria. It is like when the water stops flowing and puddles or swamps form and become contaminated.

Diabetes or hypothyroidism are very common problems that serve as examples. Also using opiate pain medications (morphine, hydrocodone) or just getting older.

SIBO is a leading cause of diarrhea and weight loss in older adults

Alteration of the defenses of the small intestine

When the things that normally protect the gut are disrupted, SIBO can occur.

For example, Gastric acid, bile, and juice from the pancreas kill bacterias in small bowel. If there is cirrhosis, pancreatic diseases or gastric acid is decreased by omeprazole, there is a greater risk of bad bacteria proliferating

Our defenses can also be altered if we are malnourished, eat poorly or are overweight

Diagnosis of SIBO Small Intestinal Bacterial Overgrowth

Duodenal fluid culture

It is considered the most important test (Gold Standard) for the diagnosis of this condition.

The test consists in that during an upper digestive endoscopy, through a special probe, the liquid that is normally in the duodenum is aspirated and this is sent for culture.

In this way, the amount of bacteria that exist is known and a sensitivity test can be taken to antibiotics.

Has the advantage that it is more precise, but it is invasive as it requires an endoscopy and, furthermore, not all laboratories analyze this sample. In practical terms, only in very few places is it done.

SIBO Bacterial Overgrowth Breath Test

In this exam, you take an envelope of lactulose dissolved in water and you are going to blow on a piece of equipment every 20 to 30 minutes for two to three hours.

When there are more bacteria than normal in the small intestine, they break down lactulose, increasing the amount of hydrogen gas which is expelled with the breath and that is why we can measure it in the breath.

The advantage of this test is that it is easy, non-invasive, and cheaper, but it has the disadvantage that it is less precise than culture.

You can schedule it with us at this link http://wa.me/573207571313

How should I treat SIBO?

Look for SIBO if there are symptoms that persist even though you’ve been tested and you still don’t know the cause. If the diagnosis of SIBO bacterial overgrowth is confirmed, I will help you in the following way:

Discover and correct (where possible) the roots of the problem. Sometimes the background or studies you have is enough, but in other cases you have to take more tests.

I’m going to give you antibiotics for two weeks. The objective of these is not to completely eliminate the bacterial flora of the intestine but to eliminate excess bacteria and calm those that remain.

Establish an individualized diet that reduces the probability of relapse of SIBO and its symptoms.

One of the options is to use one of the variants of the low FODMAPS diet. This type of intervention is very valuable when you have relapsed from SIBO or when you do not want to take antibiotics

If you want to know if you have SIBO bacterial overgrowth of the small intestine schedule your appointment for consultation / breath test by clicking this link http://wa.me/573207571313

We await your call on the phones ☎️ 60 4 3223087 or 3207571313 Look at my website http//endoscopiaycolonoscopia.com

Cheers,

Mauricio González Hernández

Your Gastroenterologist in Medellín

How is the preparation for Colonoscopy

Posted on 30 June, 2022 by admin-mauricio

The Preparation for Colonoscopy is very important for you to get the most out of this exam and help you and your doctor to find out what is happening to you

What is a colonoscopy and how is it done?

A colonoscopy is a procedure in which the inside of the entire large intestine (rectum and colon) is examined. It is recommended to diagnose symptoms such as bleeding, pain in the abdomen, diarrhea or constipation.

It is also advised for people who have no symptoms but want to prevent colon cancer or for those who have family members with polyps or colon cancer.

Before starting the procedure we will channel a vein through which we will administer the sedative that will put you to sleep. We will take care of you and you will not feel anything

For the Colonoscopy I will use a piece of equipment called a Colonoscope (a long, flexible instrument, 13mm in diameter) to see the entire interior of the colon in detail. The colonoscope is introduced through the anus, advanced to the rectum and subsequently passes through all regions of the colon until it reaches the cecum and almost always to the last part of the small intestine called the distal ileum.

On the way back I will systematically examine all the walls of the colon and if necessary I can take small tissue samples (biopsies) and remove any polyps (moles or colon warts) that I find.

Once the procedure is finished you will be taken to a recovery room. You will remain there until the great effects of the sedation wear off.

How is the preparation for Colonoscopy?

Colonoscopy preparation aims to remove all fecal matter from the colon so that I can see it properly and not miss anything. In addition, good preparation makes the procedure easier and reduces the risk of complications or discomfort after the exam.

What preparation should I get and how do I take it?:

Buy a box of Travad Pik that comes with two sachets and a glass.

The day before the exam, fill the glass up to 150 ml, pour the contents of an envelope and mix it for two or three minutes until it dissolves completely. Take it at 7 at night. After this, drink at least 5 glasses of liquid (Water, clear juice in water, tea, aromatic, aguapanela, Clight, non-carbonated soft drinks). Drink it slowly

If your exam is between 7 and 9 in the morning, repeat the above procedure with the second envelope and take it at 10 at night. Remember to drink at least 5 glasses of liquid afterwards. If your colonoscopy is after 9 a.m., have your second glass at 5 a.m. and drink 5 glasses of fluid between 5 a.m. and 7 a.m.

The preparation does not taste ugly, but you can help yourself by sucking on a candy, sandwich or panela. If you feel nauseous or vomit, stop taking the preparation, wait a while and start taking it again very slowly and in small sips.

What can I eat before the colonoscopy preparation?

Three days before the exam, avoid eating foods that contain seeds (Granadilla, Pitaya, Watermelon, grapes). The day before the exam you can have breakfast and lunch as you normally do, but hopefully you do not eat grain foods such as beans, lentils, chickpeas, peas or corn.

At the end of the afternoon you can eat a light snack such as a sandwich or arepa with ham. From then on, do not eat more solid things, but you can drink all the liquids you want, such as juices in water, aromatics, tea, red or coffee, Gatorade, jellies, consommé.

Other recommendations for Colonoscopy preparation

8-hour fast for solid foods:

As we are going to sedate you for the exam, it is important that you fast for solid foods for 8 hours so that you do not have the risk of food residues going into the bronchi (bronchial aspiration).

You must be accompanied by an adult:

Due to sedation you may see some reflexes or your ability to concentrate diminished. That is why it is necessary to come with a person who is in charge of taking you home

Do not drive or ride a motorcycle:

Driving a car or motorcycle or grilling a motorcycle increase the probability of an accident after sedation

Take your medications before the exam:

If you take medications such as those used for high blood pressure or diabetes, take them before the exam with a sip of water. If you are diabetic and you apply insulin, schedule the colonoscopy as early as possible and apply only half the prescribed dose or leave it for after the exam to reduce the risk of hypoglycemia.

Tell us about your health status:

There are conditions or illnesses that increase the risk of the exam or sedation. Therefore, if we have not previously seen you in consultation, tell us if you suffer from any delicate illness, if you have specific allergies, if you have had previous problems with sedation or anesthesia or if you take anticoagulant medications (for example warfarin) or antiaggregants (Clopidogrel or aspirin ).

If you have a respiratory infection reschedule the exam:

We are in the era of Covid and respiratory infections. That’s why if you have a fever, cough or nasal congestion, even if it’s a normal cold, reschedule the exam for when you feel better.

What can I eat after the Colonoscopy?

After the exam you can eat what you usually consume. Of course, be prudent and do not exaggerate, especially with dairy products, sweets or beans. If due to your exam or its findings, you require a specific food recommendation, we will give it to you.

In case of any inconvenience with your preparation for Colonoscopy, contact us here http://wa.me/573207571313 or call us at 6043223087 or 3207571313.

Learn more about my Endoscopy and Colonoscopy Center at https://endoscopiaycolonoscopia.com

Cheers,

Mauricio González Hernández

Your Gastroenterologist in Medellín

Preparation for Upper Endoscopy

Posted on 30 June, 2022 by admin-mauricio

Preparation for upper endoscopy (Upper digestive endoscopy or esophagogastroduodenoscopy) is a very important matter when performing this procedure because it depends on it not to take risks and to be able to see the inside of the digestive organs in the best way.

What is an upper gastrointestinal endoscopy?

An upper gastrointestinal endoscopy (or simply endoscopy) is an outpatient procedure in which the inside of the esophagus, stomach, and part of the duodenum are examined.

It is useful for diagnosing digestive symptoms such as bleeding, abdominal pain, heartburn, vomiting, nausea or difficulty swallowing.

Endoscopy allows diagnosing gastritis, ulcers or tumors and surveillance for Gastric Intestinal Metaplasia and Barret´s esophagus. It is also the best way to screening cancer of these organs

How is the digestive endoscopy done?

When you go to the procedure room, my assistant Catalina is going to channel a vein to administer the sedative that will put you to sleep. Don’t worry, we’re going to take care of you.

You are not going to feel anything. I’m going to pass an endoscope (a specialized 9 mm diameter piece of equipment) through your mouth. From there it enters the throat and then the esophagus, passing through the stomach to reach the small intestine.

During the procedure I carefully and systematically examine all the organs. In the stomach I always take a tissue sample (biopsy) to find out if there is gastritis or Helicobacter pylori bacteria.

The procedure lasts on average between 5 and 7 minutes, what is necessary to be able to take a good look at it

What happens after an Endoscopy?

Once the procedure is over, you will be taken to a recovery room. You will remain there until the effects of the sedation wear off, which can take between 5 and 15 minutes.

When you´re in perfect condition, you will be discharged together with your report. The result of the biopsies will be in four business days and will be sent to you by mail or we will see them at the review appointment if I have previously seen it in consultation.